Artikel
Intraoperative assessment and outcome in patients with bisphosphonate related osteonecrosis of the jaw (BRONJ) applying the Visually Enhanced Lesion Scope (VELscope®)
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Autoren
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Johannes Wikner
- Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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Alexandre Thomas Assaf
- Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| Veröffentlicht: | 20. Dezember 2013 |
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Gliederung
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Objectives: The aim of this prospective study was to assess the fluorescence-guided resection applying the Visually Enhanced Lesion Scope (VELscope®) in patients with osteonecrosis of the jaw induced by bisphosphonates (BRONJ). We evaluated intraoperative potentials in determining osteonecrosis and outcome.
Methods: 20 patients were included (11 females and 9 males; mean age 74 years, standard deviation ± 6.4 years), over a period of 18 month with the diagnosis of BRONJ. All patients received doxycycline marking osseous structures by flurescence. VELscope® has been used intraoperatively noting loss of fluorescence to detect absence of osteonecrosis and defining margins. In each case osseous biopsies were taken to confirm definite histopathological diagnosis of BRONJ.
Results: Diagnosis of BRONJ was confirmed in every patient. In all but one patient VELscope® was sufficient to differentiate between healthy and necrotic bone by visual fluorescence retention (VFR) and visual fluorescence loss (VFL). Nineteen cases out of 20 did not show any signs of recurrence of BRONJ during follow-up (mean 12 months, range 4–18 months).
Conclusion: VELscope® examination is a promising tool to visualize necrotic areas of the bone in patients with bisphosphonate related osteonecrosis of the jaw. Loss of fluorescence in necrotic bone areas is useful intraoperatively as a relevant tool to fluorescence-guided bone resection with relevant clinical interpretation.
